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Inflammatory Bowel Disease V: Surgical Management01:21

Inflammatory Bowel Disease V: Surgical Management

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Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
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Peripheral Artery Disease V: Postoperative Nursing Management01:23

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During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
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Peritoneal dialysis (PD) is a medical process that removes waste products and excess fluid from the body using the peritoneal membrane as a natural filter.Peritoneal Dialysis MethodsSeveral methods can be used for peritoneal dialysis, including Acute Intermittent Peritoneal Dialysis, Continuous Ambulatory Peritoneal Dialysis, and Automated Peritoneal Dialysis, also known as Continuous Cyclic Peritoneal Dialysis.Acute Intermittent Peritoneal Dialysis (AIPD) is used for patients with uremic...
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Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
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Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
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Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
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膀胱摘除術後の代用膀胱造設術における長期合併症と機能

Mads Jacob Haugaard Hansen1, Maja Vejlgaard1, Mie Skjøttgaard Ynddal1

  • 1Urological Research Unit, Department of Urology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital - Rigshospitalet.

Danish medical journal
|February 25, 2026
PubMed
まとめ

膀胱摘除術後の代用膀胱造設術（CCUD）は、患者の尿禁制率を高める。しかし、5年以内に再手術が必要となる患者がほとんどであり、尿路変向管理におけるトレードオフが浮き彫りになる。

キーワード:
代用膀胱造設術尿路変向膀胱摘除術長期予後合併症尿禁制

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科学分野:

  • 泌尿器科学
  • 外科腫瘍学
  • 腎臓学

背景:

  • 代用膀胱造設術（CCUD）の機能的転帰に関するデータは限られています。
  • 本研究は、尿路変向術における共有意思決定に洞察を提供することを目的としています。
  • CCUD造設を伴う膀胱摘除術後の長期転帰を調査することは重要です。

研究 の 目的:

  • 代用膀胱造設術（CCUD）の長期機能的転帰を調査すること。
  • 尿路変向術を受ける患者の共有意思決定を導くこと。
  • 膀胱摘除術後のCCUDによる尿禁制率、再手術リスク、合併症、腎機能を評価すること。

主な方法:

  • CCUD（2010-2023年）で膀胱摘除術を受けた患者50名のカルテの後ろ向きレビュー。
  • 主要評価項目：尿禁制率。副次評価項目：晩期再手術、合併症、腎機能。
  • 競合リスク分析を用いて、再手術の累積リスクを計算しました。

主要な成果:

  • 中央値追跡期間は5.7年でした。
  • 術後中央値167日以内に92%の患者が3時間尿禁制を達成しました。
  • 再手術の累積5年累積リスクは71%であり、2/3の患者が少なくとも1回の再手術を必要としました。

結論:

  • 代用膀胱造設術（CCUD）は、膀胱摘除術後の患者に高い尿禁制率を可能にします。
  • 患者の大多数（71%）が5年以内に再手術を必要とします。
  • 共有意思決定では、尿禁制達成と高い再手術率を考慮する必要があります。